The investigators will study the efficacy of a novel cellular phone messaging system to communicate health information and facilitate early return to clinic after abnormal laboratory results in rural Uganda.

Cellular phone text message formats to be sent to participants after abnormal laboratory results to communicate information and request early return to clinic.

Active Comparator: Direct Text Message+PIN-code activation

Other: Cellular Phone Text Message Formats

Cellular phone text message formats to be sent to participants after abnormal laboratory results to communicate information and request early return to clinic.

Active Comparator: Coded Text Message

Other: Cellular Phone Text Message Formats

Cellular phone text message formats to be sent to participants after abnormal laboratory results to communicate information and request early return to clinic.

Detailed Description:

Among the challenges that complicate optimal health care delivery in rural settings is lack of communication between care providers and patients. Communication of abnormal laboratory results represents a particular challenge. Laboratory and other test results are often not reported until repeat visits weeks to months later. In the case of treatment failure, severe treatment complications, or evidence of opportunistic infection, such reporting delays likely result in adverse outcomes and potentially compromise future treatment options. The investigators propose to evaluate a novel strategy of communication using SMS text messaging to facilitate patient return to an HIV clinic in Uganda after critical laboratory results.

The investigators will consent and enroll participants at the time of laboratory testing for CD4 count, viral loads, acid fast bacteria smears of sputum, among others. Those with abnormal results will be randomized to various messaging formats and receive text messages requesting a prompt return to clinic. For outcomes, the investigators will measure successful receipt and comprehension of messages, as well as proportion returning within 14 days of the abnormal laboratory test.

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Please refer to this study by its ClinicalTrials.gov identifier: NCT01579214